Is there a timing for sensitivity to acute cerebral ischemia in migraine patients?

JOURNAL OF THE NEUROLOGICAL SCIENCES

卷:408

Article

Francillard, Isabelle¹  Grangeon, Lou¹  Cornillot, Agathe²  Houivet, Estelle³  Ozkul-Wermester, Ozlem¹  Triquenot-Bagan, Aude¹  Hebant, Benjamin¹  Maltete, David¹  Gerardin, Emmanuel²  Guegan-Massardier, Evelyne¹ 

[1] Rouen Univ Hosp, Dept Neurol, F-76031 Rouen, France

[2] Rouen Univ Hosp, Dept Radiol, F-76031 Rouen, France

[3] Univ Rouen, Rouen Univ Hosp, Dept Biostat & Clin Res, INSERM U 1219, Rouen, France

关键词: Migraine;    Cerebral ischemia;    CT perfusion;    Infarct growth;    Mismatch pattern;    Cortical spreading depression;    Reperfusion;   

DOI  :  10.1016/j.jns.2019.116528

来源: Elsevier

【 摘 要 】

Background: Migraine may be a factor of increased cerebral sensitivity to ischemia. Previous studies were conducted within 6 to 72 after stroke onset. We aimed to determine if an accelerated infarct growth exists in migraine patients within the first 4.5 h. Method: A retrospective case-control study was conducted where all patients admitted for acute stroke started < 4.5 h before and who underwent perfusion CT were assessed. The hypoperfusion and necrosis volumes on initial CT perfusion were analyzed, as well as the final infarct volume on MRI performed within 72 h after admission. A no-mismatch pattern was defined as a ratio necrosis/hypoperfusion volume > 83%. Results: 24 patients with personal history of migraine were identified, 8 of them with aura. The control cohort included 51 patients. No difference was found between groups in terms of demographics, initial severity or outcome or presumed cause of stroke. Mean time to CT scan was 125 min in migraine patients and 127 min in the control group. A no-mismatch pattern was equally found in migraine patients and controls, even after adjustment for age, sex and presence of proximal occlusion (p = .22). The final infarct volume was also similar in both groups. Conclusions: Migraine patients did not display more no-mismatch pattern than controls within the 4.5 h of stroke onset. This deviates from previous studies and may be due to our earlier time from stroke onset to CT scan. A history of migraine may lead to malignant progression of ischemia but occurring only after several hours.

【 授权许可】

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